14110014CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20984 ALVES DR I CONTRACTOR: ALPS CONSTRUCTION & I PERMIT NO: 14110014 REMODELING I
OWNER'S NAME: GAMPALA RAVIKUMAR S AND CHITTAJALLU 11011 S DE ANZA BLVD I DATE ISSUED: 03/25/2015
OWNER'S PHONE: 4084800602
❑ LICENSED CONTRACTOR'S DECLARATION
License Class --6— Lic. # —l_ -I � J _]
Contractor A/' 2_3 Cmvn 4irlAL %9YI Date(I�/7 / /5
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances Arid state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature'� Date U j 2h I
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code),
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
SAN JOSE, CA 95129 I PHONE NO: (408) 898-6474
JOB DESCRIPTION: RESIDENTIAL [:] COMMERCIAL E]
CONSTRUCT 2 STORY SFDWL IST FLOOR; 2308 SQ FT,
2ND
FLOOR 1972 SQ FT, BASEMENT 1458 SQ FT W/ ATTACHED
GARAGE 688
Sq. Ft Floor Area: I Valuation: $900000
APS Number: 32631004.00 I Occupancy Type: I
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS F LAST CALLED INSPECTION.
Issued by: Date:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materialsrequirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent: ti Date:
IV
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
CSU"PERTINO I
IFI NFW C(1N.CTRI ICTION
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(Exicupertino.org,
F-1 ADDITION n ALTERATION/TI FI REVISION /DEFERRED
ORIGINAL PERMIT N
PROJECTADDRESS dCI46q /I /VCS O f,
I/I
APNN 3��3 I M. 1, ��/1 ,
OWNERNAME (�'U11✓Vq �JQ,IC?P/V
PHONE 116 �'/ qA oO6Oz
o/lu_�1 D�I_)m
F-MAILI$"A-a�G6 P/Q `✓1'W41'•WM
��/
STREET ADDRESS )g 1 Y In /1 IV's $ �1'�"
/`7~r
CITY, STATE, ZIP
�,
1�/
FAX
CONTACT NAME All -ani0/
PHONR /JQ c&e( G'/ 61/71
T
IZIPD
E-MAIL
STREET ADDRESS 1011 5 P`eJ^ nz& r}1 I
{'1
CITY, STATE',
,I
nO�G3D`/ ) �'YI��
FAX
❑ OWNER D OWNER-B%UIIL/DER ❑ OWNERRbAGENNTT 0 CONTRACTOR COI RACTORAGENI' ❑ ARCHITECT LIENGINEER El DEVELOPER ❑ TENANT
CONTRACTOR NAME /to/ iC„Im S�.,I,Ne.+ a,�n/�
LICENSENUMBGR C'{/('qj� 3'L'2
LICENSEET�YPE 13
BUS. LTC4
COMPANY NAME /1 /II'iyS �lCJi1 fW`�r"YU ID9ir(
J l
E-MAIL (I. ;I 00715 7-aC,+(6-n O.Jy0.hOU,CO Nt
FAX
STREETADDRESS !le �m.L� �1 v'�
I/ V
CITY, STATE, ZIP 'r"A 7usC 5 CIAx/1612._l
_I'/ 4
PHONE
ARCHI'T'ECT/ENGINHER NAME
LTC ENRENUMBER -
BUS. LICK
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK 1
i3rum 1v�,t✓ �j�Jm1 1'b7m. ' 3 Sd�'rl�s
EX
Fesr
Y_/ 6a
R TYPE
A(
9STORIES
3
USE
TYPE
OCC.
SQ.F"1'.
VALUATION($)
EXISTG
AREA
NEW FLOOR
A
DEMO
AREA
'TO'T'AL [ r
NETARGA
9368
too
BATHROOM
KITCHEN OTHER
REMOma.AkEA
REMODEL AREA REMODEL AREA
'111.
1q -7Z
PORCH AREA DECK AREA
TOTAL DECK/POKCH AREA
GNIAGEAREA: EIDIAACII
II DWELLING UNITS:
IS A SECOND UNIT AYES
SECONDSTORY L]YES
BEINGADDEII? EJNO
ADDITION? [INO
4
�0,
PRE -APPLICATION L]YES W- YES, PROVIDE COPY OF
IS THE BLDGAN E]YES
RECEIVED EY,
TOTAJ., VALIATION:
PLANNING APPI,H ENO PLANNING APPROVAL LETTER
EICHLER HOME? QNO
`/Ill/1'GI�
By my signature below, I certify to each of the following: I am the property owner or author Ized agent to act on the property, owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and stale laws relating (ding lstruCB011. I authorize representatives of Cupertino to enter the above^-pidentified7 property for inspection purposes.
Signature of Applicant/Agent ' Dale: I o 1 o ! CI
SUPPLEMENTAL INFORMATION REQUIRED
Pian CHECK TYPE
ROQ,TINGSLII' -
❑-OVERTnDCOUNTER
11-131TILDINGPLAN REVIEW'
NeWSPDorMultifamii),dwellings: Apply for demol ition permit for
existing building(s). Demolition permit is required prior to issuance of building
- =.
permit for Dow building.
EXPRESS
—PLANNING PLAN RCVIEW
/
Bldgs: Provide a completed Hazardous Materials DisclosureSTANDARD
HBLICWOR<S
_Commercial
fmTn if any Hazardous Materials are being used as part of this project.
-rlrz
LARGE
nEl'
_ Copy of Planning Approval Letter or Meeting with Planning prior to
❑
SANITARY
submittal of Building Permit application.
MAaoa
- SEWCR DISTRICT -
❑: ENVIRONMENTAL TICAL"L'H '
BIdEApp_20l l.doc revised 06/21/11
CITY OF CUPERTINO
1l�I FEE ESTIMATOR — BUILDING DIVISION
19
ADDRESS: 20984 alves dr
DATE: 11/03/2014
REVIEWED BY: Mendez
PC FEE ID
APN:
BP#: / OV
°VALUATION:
$900,000
^PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex
USE:
2nd Unit? 0 Yes '- No
PENTAMATION
PERMIT TYPE: 1R3SFD
WORK
construct 3 storysfdwl 1st floor; 2308 s ft2nd floor 1972 s ftbasement 1458 s ft w/ attached
SCOPE
garage 688.
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,111-B,IV,V-B
6,427
$3,698.65
IR3PLNCK
$5,010.10
IR3INSP
Permit Fee:
$5,010.10
Supp/. Insp. Fee -.(F) Reg. 0 OT0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BcoNSTnxR
1
N new
,,nits
$667.73
A2 hninistrativc Pee:
Work Without Permit? ® Yes (D No
$0.00
TOTALS:
6,427
$3,698.65
Tnnel 17uculnentaiiul� 1 ees
1 $5,010.10
Strong Motion Fee: IBSCISMICR
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
MovirL elr_ L These fees are based on the nreliminary information available and are only an estimate. Contact the Dept for addn'I info.
FEE ITEMS (Fee Resolution 11-053 Ef' 7/1/13)
Meeh. Plan ( he, k
Phr,nb. Plan ('h, A
glee. Man Cse<lf
1kch Peinti( Pee'
Plumb. fermi:I ve:
(Tec Pernrir her'
Orbe, t Oc Vii. Ins/�.
Odre, Plumb7nsp_
Orherlag,. Insp.
i14ech Lasp_ tee:
Numh bx•p. f=ee-
1:-Icc.Imp, Pee -
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
MovirL elr_ L These fees are based on the nreliminary information available and are only an estimate. Contact the Dept for addn'I info.
FEE ITEMS (Fee Resolution 11-053 Ef' 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$3,698.65
Select a Misc Bldg/Structure
or Element of a Building
A
Suppl. PC Fee: Q Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check
$0.00
Permit Fee:
$5,010.10
Supp/. Insp. Fee -.(F) Reg. 0 OT0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BcoNSTnxR
1
N new
,,nits
$667.73
A2 hninistrativc Pee:
Work Without Permit? ® Yes (D No
$0.00
Advanced Planning Fee: 1PLLONGR
$899.78
Select a Non -Residential
Building or Structure 0
A
Tnnel 17uculnentaiiul� 1 ees
Strong Motion Fee: IBSCISMICR
$117.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$36.00
SUBTOTALS:
10,429.26
$0.001
TOTAL FEE:
$10,429.26
Revised: 10/01/2014
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 14110014
20984 ALVES DR CUPERTINO CA 95014 (326 31 004)
OWNER'S NAME: GAMPALA RAVIKUMAR S AND CHITTAJALLU
OWNER'S PHONE:
LICENSED CONTRACTOR'S DECLARATION
License Class B Lie. #2Q 433'
Contractor Date 0713112016
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
1. I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
I certify that I have read this application and state that the above
Information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
representatives of this city to enter upon the above mentioned property for
Inspection purposes. (We) agree to save Indemnify and keep harmless the
City of Cupertino against liabilities, judgments, costs, and expenses which
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will comply with all non -point
source regulations pe,_r-f7(�-Qupertino Municipal Code, Section 9.18.
Date 513112016
hereby affirm that I am exempt from the Contractor's License Law for one of the
Blowing two reasons:
1. 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
2. f, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code),
hereby affirm under penalty of perjury one of the following three declarations:
1. 1 have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
a. I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California. If, after making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws
relating to building construction, and hereby authorize representatives of this city
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City In
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature Date 513112016
1011 DE ANZA BLVD
SAN JOSE, CA 95129
DATE ISSUED: 03/25/2015
PHONE NO: 408-412-4309
BUILDING PERMIT INFO:
—BLDG —ELECT —PLUMB
MECH RESIDENTIAL COMMERCIAL
JOB DESCRIPTION:
CONSTRUCT 2 STORY SFDWL 1ST FLOOR; 2308 SQ FT, 2ND
FLOOR 1972 SQ FT, BASEMENT 1458 SQ FT W/ ATTACHED
GARAGE 688
REV#1 -ADD FIRE PLACE- ISSUED 5/31/2016
Ft Floor Area: I Valuation: $900000.00
I Number:
31 004
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
RE - ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
hire ofApl
5/31/2016
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, S tions 25505, 25533, and 25534.
Owner or authorized agent: a
Date: 5131/2016
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Address
ARCHITECT'S DECLARATION
understand my plans shall be used as public records.
��CUPERTINO
IJ NEW CONSTRI
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX ((408) 777-3333 • buildinpacuoertino.om
❑ ADDITION LI ALTERATION / TI (REVISION/ DEFERRED
�U1104 pe,) -A I
ORIGINAL PERMIT p
PROJECT ADDRESS ry \/ t t� L
OWNERNAME PHONE
Oil—
E-MAILkm —
STREET ADDRESS CITY, STATE, ZIP
FAX
CONTACT NAME I p /t ,n/j m
L l lib � Vru,
PHO' Fy1�1 IOQ O
o�l 0 1(f
E-Mmb W'0 1'a
E / J_P l�_V' / ✓`„
STREETADDRES) CITY, STATE, ZIJP
El OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑
ARCHITECT ❑ ENGINEER ❑ DEVELOPERV ❑ TENANT
CONTRACTORNA
` I _ ,�
���-
L7CENSENUMBE
LICENSE TYPE
BUS. LIC# -
COMPANY NAME
13 -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS CITY, STATE, ZIP
PHONE
c
DESCRIPTION OF WORK tl(/
EXISTING USE
PROPOSED USE
CONSUITYPF:
#STORIES
I
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEWFLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN OTHER
REMODEL AREA
REMODELAREA REAODELAREA
PORCH AREA DECKAREA
'TOTALDECK/PORCH AREA
GARAGEAREA: DETACH
[] ATTACH
#DWELLMGUNITS:
IS A SECOND MIT [IYES
SECOND STORY (]YES
BEING ADDED,ONO
ADDITION? ONO
PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF
ISTHEBLDGAN ❑YES:
RECEIVED BY
TOTAL VALUATION:
PLANNINGAPPL# Fl NO PLANNING APPROVAL LETTER
EICHLERHOME? E]NO
Ey my signature below, I certify to each of the following; I am the property owner or authorized agent to act on the p perry ow er's behalf. 1 have read this
application and the information I have e d is correct. I have read the Description of Work and verify it is
accurate. I agree to comply with al] applicable local
ordinances and slate laws relating to u}' Og c nstmction, I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature ApplicanUAgent; Date:
of
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CIIECK TWE-
ROUTING Sur
❑ OVER—TBE—COUNTER
❑ BUILDING PLAN REVIEW
New SFD of Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS
❑ PLANNINGPLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE`
❑ ?IRE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAJOR'
LI SANITARY sewEAmsTmeT "
submittal of Building Permit application.
❑ EM'IRONMENTAL HEALTH
BldgApp_2011. doe revised 06121111
1104{
CUPERTINO
PURPOSE
UTILITY RELEASE REQUEST FORM
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.org
For residential single family or duplex construction, there are cases where gas and electric utilities are
requested to be released prior to the issuance of the certificate of occupancy. Upon approval from the
building inspector, the City of Cupertino is allowing both utilities to be released prior to the final sign -off of
the building.
INSTRUCTIONS
1. Download this form at: http://www.gMertino.org/index.aspx?page=297.
2. Complete the form and obtain signatures from both the owner of the property and the primary contractor.
3. Fax, E -Mail, Mail or hand deliver the original signed form to:
City of Cupertino
Building Division
Attn: Utility Release Request Form 408-777-3228 office
10300 Torre Ave. 408-777-3333 fax
Cupertino, CA 95014 buildinggcupertino.ore
4. Schedule a Gas Meter Release inspection (#403) and/or Electric Meter Release inspection (#404). Please
note, a Gas Test inspection (#506) is required prior to or at the same time of the Gas Meter Release
inspection.
BUILDING INFORMATION (Please complete the following information):
APN
BLDG PERMIT M -
11 _ 000/
DATE:
12 1 2-016
SITE c�
ADDRESS: ZO / 4 A L V _S J] Z I LI c:
; C_ U IP C I L I J N O �-I , o f
OWNER'S NAMES. At\t -� 1j A Ci,- 1 t \ A S ALL U
_
PHONE #:
FAX #:
�.� O r-- �/ O�
4-c);? -.- U
MAILING ADDRESS (if different from site address): a
��f - :3 C C- T& -p, cGo� SI��J 1-4 S(
(En
1
CONTRACTOR:PHONE
AAt ZiaM'5LK%
M
-4t b e ec? S 6 4(
FAX #7
CONTACT:_
A LLQ
PHONE M
FAX #:
I request the City to release my utilities prior to obtaining a final inspection approval for the building. I fully understand the occupants of
the building cannot move into the residence until they receive all of the required final sign -offs and the City has issued a certificate of
occupancy for the building.
Owner:.,..:.............................................................Print:.s�/��a..yi�....�..r�..1.S...l..%�,A.L.L.U..bate:.....�.Z..f.�...�.Zt�.l.
. ✓644
Contractor:...'.................................................... Print: .......... I!'-AL......�r..-..ikM°t..+.?.t..................Date:...t'?—,d3/..16.......
UtilityReleaseForna_2011.doc revised 08109111
CONTRACTOR SUBCONTRACTOR LIST
Alves Dr PrD fT, 14 4
10
wmm���
City Of elipi rano
1030.0 Torre Me n u e
C"Pextil-lo, CA 95014 3255
Telcphonc. 408-777-3228
Fox 408-777-3333
�2w I ft
"'ER'S NAME.Santha Chittajallu & Ravi 08-480-0602
i GENERAL CC:ONTRACTOR. Ali's Construction & Remodeling Inc.
S., #28677TI�o
t T SS 1011 S. De Anza 1�
T)l- /KTPCODE. San Jose, CA 95129
Blvd.
SSLAS working in the city to have a CiCy of Cup#rtillo blls
411ess license.
NO BUILDING MAL Olt -FINAL OCCUPANCI, IN,,PECTION(S) WNN- ILI ' RE SCHEDULED UNTIL THE
GENFRAI 0)NTRACTONNIS ALL SUBCON'TRACTOW, "A.,vF OBTAINED A CITE;' OF CUPERTINO
BUSINESS LICENSE.
11111HOt using, ally Sttbc0,jjtrAct0r8,
Date
Please ch-eck-applicable subcolit.r-actoli's and contj)lete t1je followiliq
V
S
SUBCONTRACTOR
"'CONTRACTOR
_BUSINESS
BUSINESS NAME
Blue Sierra Construction Inc. _
Gotfloor com
--
BUSINESS LICE N SE#
Cabinets & Millwork
ji
E
__M
C ej�,t I
Cement Finishing,
36413
x
8kcavation
Fencing
28600/4 L
x
1,400ring
Lhi.oleum / XVood
Glass / Glazing
x
Fleatin
. 9
Melgar Heating & Air
36596
Insufati(m
Landscaping
Lathing
E..
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Painting Wallpaper
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J E Johnson Roofing
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2/14/17
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